Gras-Cabrerizo Juan R, Gras-Albert Juan R, Monjas-Canovas Irene, García-Garrigós Elena, Montserrat-Gili Joan R, Sánchez del Campo Francisco, Kolanczak Katarzyna, Massegur-Solench Humbert
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
Servicio de Otorrinolaringología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España.
Acta Otorrinolaringol Esp. 2014 Jul-Aug;65(4):242-8. doi: 10.1016/j.otorri.2014.02.002. Epub 2014 Apr 6.
Local pedicle flaps based on the sphenopalatine artery make it possible to reconstruct large defects of the skull base (SB).
From January 2008 to January 2013, 64 lesions with involvement of SB were analysed. These lesions were treated using endoscopic endonasal approach and required a pedicle flap based on the sphenopalatine artery. In addition, measurements and flexibility of the flaps were examined in 4 cadaveric nasal cavities.
Surgical group. Sixty-four nasoseptal flaps (NSF) were used, in 4 cases associated with a middle turbinate flap (MTF), and in 1 case supplemented with an inferior turbinate flap (ITF). Five cerebrospinal fluid fistulas (8%) were noted. Among patients with initial lesions, 7% presented an anosmia. Cadaveric group. The length of the NSF varied between 5.2 cm and 7.7 cm and the width ranged from 3 cm to 4.5 cm. The ITF provided an anterior-posterior distance between 4.2 cm and 5 cm, with a width between 1.2 cm and 2.8 cm. The mean length of MTFs varied between 3.5 cm and 4.2 cm, with a width between 1.4 cm and 1.9 cm.
The most versatile local flap for the reconstruction of skull base defects is the NSF, and flaps pedicled to the posterolateral nasal artery offer an excellent alternative.
基于蝶腭动脉的局部带蒂皮瓣使得重建颅底（SB）的大缺损成为可能。
对2008年1月至2013年1月期间64例累及颅底的病变进行分析。这些病变采用鼻内镜鼻内入路治疗，需要基于蝶腭动脉的带蒂皮瓣。此外，在4个尸体鼻腔中检查了皮瓣的尺寸和灵活性。
手术组。使用了64块鼻中隔皮瓣（NSF），4例联合中鼻甲皮瓣（MTF），1例补充下鼻甲皮瓣（ITF）。发现5例脑脊液漏（8%）。在初始病变患者中，7%出现嗅觉丧失。尸体组。NSF的长度在5.2厘米至7.7厘米之间，宽度在3厘米至4.5厘米之间。ITF的前后距离在4.2厘米至5厘米之间，宽度在1.2厘米至2.8厘米之间。MTF的平均长度在3.5厘米至4.2厘米之间，宽度在1.4厘米至1.9厘米之间。
用于重建颅底缺损的最通用局部皮瓣是NSF，带蒂至鼻后外侧动脉的皮瓣是一种极佳的替代方案。
